Definition Of Type 2 Diabetes-Diabetes Mellitus is derived from Greece (diabetes mellitus, glow = = sugar). So this disease literally means the existence of a steady stream of sugar or the presence of the excess sugar in the body. Therefore, it’s no wonder the disease known as diabetes mellitus.
Diabetes mellitus is a group of heterogeneous disease which generally picture is hyperglycemia. Simply put this disease can be distinguished/classified in two variants which are distinguished based on the pattern of inheritance, and insulin response. However, in its development has found a new classification based on the etiology of the disease. Such diseases, among others;
- Type 1 diabetes mellitus (insulin dependent diabetes mellitus –/diabetes onset juvenilis) which occurred in 5% – 10% of diabetes mellitus,
- Diabetes mellitus type 2 (diabetes mellitus non-insulin dependent diabetes adult onset/) that occurs in approximately 80% of patients who suffered from diabetes mellitus and
- Diabetes is caused by a specific cause that occurs in 10% of cases of diabetes mellitus.
On this LTM will only be discussed on type 2 diabetes mellitus.
Definition of type 2 Diabetes Mellitus
Diabetes mellitus type 2 or often called with Non-Insulin Dependent Diabetes mellitus (NIDDM) diabetes is caused by the occurrence of resistance of the body against the effects of insulin produced by the pancreas beta cells. This situation will cause the sugar levels in the blood to be uncontrolled. Obesity and a family history of suffering from diabetes risk factors thought to be the onset of this disease.
In this type of diabetes, genetic factors are more important role compared to on diabetes type 1A. Among identical twins, concordance (emergence of heredity on the second pair of twins) is 60% to 80%. On has a close family of the patients of type 2 diabetes (nonidentical twins and on) the risk of suffering from the disease is five to ten times greater than the subject (with the same age and weight) that does not have a history of illness in his family.
Pathogenesis Of Diabetes Mellitus Type
In essence, this type 2 diabetes occurs due to predisposing genetic(disorders of insulin secretion in beta cells and insulin resistance) and a mix of environmental factors (such as obesity).
1. Disorders of Insulin Secretion In Beta Cells
At the beginning of the journey of type 2 diabetes, insulin secretion and insulin levels look normal plasma did not diminish. However, collectively, this and other observations suggests the presence of impaired insulin secretion found in early type 2 diabetes, not a deficiency of insulin synthesis. Travel sickness the next absolute insulin deficiency occurred mild to moderate. Then going on to lose 20% – 50% of the beta cells, but this has not been able to cause failure in insulin secretion is stimulated by glucose. However, what happens is the presence of disturbances in the introduction of glucose by the cells of the beta.
Loss of signal the introduction of glucose by the cells of the beta can be explained by two mechanisms:
a) an increase in UCP2 (uncoupling protein 2) beta cells in people with type 2 diabetes mellitus can cause loss of signal typical of glucose on the disease.
UCP2 is a Mitochondrial protein that separates the biochemical respiration of oxidative phosphorylation (so as to produce heat instead of ATP) which are then expressed in cells of the beta. High intracell UCP2 levels will weaken the insulin response while the low levels will strengthen it.
b) presence of islet amyloid deposition in
In 90% of patients with type 2, diabetes discovered deposits of amyloid at autopsy. The main component of Amylin amyloid that settles this normally generated by the beta cells of the pancreas and secreted with insulin in response to glucose allotment. However, if the insulin resistance occurs caused hyperinsulinemia, then it will have an impact on increasing the production of amyloid in the islet. Amylin surrounding cells beta cells causes rather refractory in receiving signals of glucose or in other words the nature of the toxic amyloid beta cells for so it probably acts causing damage to cell beta.
Obesity can also be the cause of the onset of diabetes mellitus type 2 is due to obesity may increase insulin resistance to a stage that can no longer be compensated by increasing the production of insulin. The concept of insulin resistance is as follows: at first look, there is resistance from the target cells towards insulin work. Early insulin binds himself to the receptor-specific cell surface receptors, the reaction occurs then intracellular which increases the transport of glucose penetrate cell membranes. In patients with type 2 diabetes, there is an abnormality in the binding to insulin receptors. This can be caused by a reduced number of places responsive insulin receptors on cell membranes. As a result of the abnormal merger between complex insulin receptors with a glucose transport system.
So it can be inferred that the insulin resistance that is closely related to obesity cause excessive stress on the beta cells that eventually wound up in the face of increased insulin needs.
Risk factors associated with the onset of type II DM process, such as:
1) age (increasing at above 65 years of age)
3) family history
4) ethnic groups
less physical Activity 5)
6) other diseases